It seems intuitive—if you cut funding for abortions, abortions will decrease. This was the thinking of Presidents Ronald Reagan and George W. Bush when they supported the Mexico City Policy, which reduced federal funding to non-governmental organizations (NGOs) that performed or promoted abortions. Recent research at Stanford Medical School shows however that cutting abortion funding may have actually led to an increase in the number of abortions performed in Africa.
Dr. Eran Bendavid and Dr. Grant Miller, along with Patrick Avila, completed a study of over 260,000 women in 30 Sub-Saharan African countries from 1994 to 2008. They found that abortions were 2.55 times more likely in countries that received a large amount of U.S. government funding as compared with those that received relatively little funding.
In 1984, President Reagan introduced the Mexico City Policy which prevented the U.S. Agency for International Development (USAID) from funding NGOs that advocate abortion, such as the International Planned Parenthood Federation and Marie Stopes International. The policy was implemented by Executive Order and was an extension of the Foreign Assistance Act of 1961. President Clinton rescinded the policy in 1993 and President George W. Bush reinstated it in 2001. As he argued “It is my conviction that taxpayer funds should not be used to pay for abortions or advocate… abortion, either here or abroad.” In a continuing partisan fashion, President Obama again rescinded the policy in 2009.
It is important to note that abortion in most African countries has been and continues to be illegal. On average, there are 14.5 abortions per 10,000 women (ages 15-44) in Africa as compared with 196 abortions per 10,000 women in the U.S. While there are 14 times more abortions performed in the U.S. than in Africa, many abortions in Africa are performed in an unsafe manner and may be the cause of up to 50% of maternal deaths.
In their paper “United States Aid Policy and Induced Abortion in sub-Saharan Africa,” the Stanford researchers chronicled what seems to be a simple phenomenon of economic substitution. Assuming that women see contraception and abortion as their two major ways of preventing unwanted births, they will substitute abortion when contraception supplies decrease. By cutting funding for abortion services, the Policy inadvertently reduced the availability of contraceptives as organizations operating in Africa slowed operations, especially in rural areas, due to cuts in their federal funding.
For policymakers, this report presents a clear case of principle vs. pragmatism. Republican presidents, on principle, cannot approve the use of federal funding to support the killing of unborn African children. However, by denying funding to groups working on the ground, the Mexico City Policy may effectively leads to more deaths. A more pragmatic approach might lead the next Republican president to forgo the policy, with the knowledge that there will be fewer abortions as a result. While further work is required on the issue, this study highlights the importance of evaluating policy impacts (and unintended consequences) in a pragmatic way as opposed to just making decisions based on principle.